Student learning occurs in clinical settings with direct student-patient contact, with safety being a critical component of each clinical course. The right of patients and the public to safe professional practice supercedes the student's learning and skill acquisition needs. It is the responsibility of the University, School, and the faculty to protect those involved in the clinical setting from dangerous situations. Faculty have the obligation to assess and make professional judgment with respect to each student's fitness for safe clinical practice. Student impaired clinical performance includes, but is not limited to, a student functioning while under the influence of alcohol or controlled substances or under psychological distress.

Students who are currently licensed by the Commonwealth of Pennsylvania must follow the procedures specified by the State Nurse Practice Act and the State Board of Nursing. Students licensed in another state will be expected to follow procedures specified by the Nurse Practice Act in the state where they are licensed. Any evidence of impaired practice in a licensed RN who is functioning in the role of an RMU student nurse must be reported to the State Board of Nursing in which the student is licensed for further investigation. The State Board may suspend the RN's license to practice, but halt further disciplinary action if the RN agrees to participate, and is eligible for the Voluntary Recovery Program. The School of Nursing will follow the policies and procedures of that program regarding assessment, treatment, and school monitoring.

When a faculty member makes a professional judgment that a student's physical and/or psychological condition has impaired his/her ability to perform in accordance with course-specific clinical behaviors, the student will be asked to leave the clinical area. When the clinical agency has a policy regarding fitness for duty, in addition to the RMU nursing policy, that policy will be followed.

Procedure

1. When there is concern that a student poses a risk of harm to self, patients, or others in the environment, the faculty member should remove the student from the clinical area.
   
   
2. When the clinical agency has a policy regarding fitness for duty, the agency policy will also be followed.
   
   
3. If needed, and at the faculty member's discretion, the clinical instructor or a representative from the school may accompany the student to the nearest healthcare facility for emergency treatment and/or testing, prior to bringing the student to the department for a meeting.
   
   
4. The student is informed of this temporary suspension from clinical practice and is sent to the Department of Nursing for an immediate meeting with an administrator. Transportation to the school of nursing will be provided via taxi service.
   
   
5. The documented evidence of impaired clinical performance is reviewed with the student and the student has an opportunity to provide an explanation.
   
   
6. If the student requests a formal hearing, one will be conducted in accordance with the Robert Morris University's judicial procedures.
   
   
7. Before being permitted to return to the clinical area, the student may be mandated to obtain a health assessment including necessary follow-up testing and/or counseling which may be completed through the emergency department or at any healthcare facility authorized by the student's health insurance carrier, at the student's expense. The assessment shall include a release to return to the health care/clinical environment.
   
   
8. The student has the right to refuse this assessment, treatment, and further monitoring. However, the Department of Nursing may inform the student that he/she is not permitted to return to clinical practice without certification from a recognized healthcare provider that he/she is either undergoing treatment or does not need treatment and is fit for duty.
   
   
9. If the student has been referred to treatment, the student will be permitted to return to clinical practice only on the specific recommendation of an appropriate treatment provider that the student is capable of safe and skilled clinical performance.
10. Refusal by the student to follow any step of this procedure may result in dismissal from the school of nursing or in indeterminate suspension.
    
    
11. Confidential medical information will be maintained in a restricted file in the RMU Department of Nursing.
    
    
12. Information will be shared with treatment providers and others designated by the student only with the student's written consent.
    
    
13. No information will be shared unless there is a clear and direct need to know.
    
    
14. The student and a representative of the Department of Nursing will sign a return to school agreement, individualized according to the student's needs. This agreement will delineate the terms of the student's return to clinical practice.
    
    
15. The Department of Nursing has the right to impose conditions on the student's return to clinical practice as necessary following treatment and consistent with the objective of providing safe and skilled clinical care.
    
    
16. The Department of Nursing will provide monitoring of the student as needed following return to school and clinical practice.
    
    
17. Any subsequent behaviors that indicate unsafe clinical performance will result in additional procedures being followed as detailed herein or dismissal from the school, dependent upon the nature, extent and/or severity of the behaviors.

Faculty Approval: 12/19/06